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NASN: School Nursing in Canada and the US: An Opportunity to Strike a New ‘Bargain’

Targeted News Service

SILVER SPRING, Md., March 18 -- The National Association of School Nurses issued the following news release:

As leaders in school health in Canada and the United States gather this week in Baltimore, representatives from nurses associations in both countries will be presenting the arguments for better long term policy and stable funding from the health systems for one of the best investments in prevention and health promotion...the school nurse.

School-based and school-linked preventive health services have been examined in a variety of studies on a variety of topics and consistently found to be effective and more cost-effective that services delivered in other venues. And, obviously, within those different services, nurses play the key role.

As well, there is a consistent theme in the research about school health promotion (which includes sets of coordinated programs such as classroom instruction, parental involvement, policies on health topics, student engagement on school activities etc.) that designating coordinators/facilitators at the school and local health authority/school board levels is necessary, efficient and effective. Again, nurses can and should play that role.

In Canada, recent reviews of the nursing workforce in Canada have revealed that most provincial/territorial jurisdictions have not established appropriate policies and standards of practice for school nursing despite recent advances that have been made in school health promotion overall. A recent review conducted by the Canadian Nurses Association indicates that public health nurses are well situated to significantly influence the health and education outcomes of Canada's school age population and to build effective structures and processes that support school communities to identify and respond to the needs of the populations they serve.

"The advancement of public health nursing in Canadian schools requires significant support from several sectors and levels of governments, but will produce important returns," said Canadian Nurses Association president Barb Mildon. "A national strategy that defines the roles and contributions of public health nurses is an important step in bringing enhanced preventive health services to a large portion of our population via schools."

In the United States, school nurses and school-based health services have previously filled some of the gaps in health insurance coverage. With the introduction the Affordable Health Care Act and related expansion of Medicare coverage, school nurses can be a significant part of the greater focus on prevention now developing across the country.

A recent blog post from NASN staff member Shirley Schantz has noted that "As school nurses we know that for some children their only access to health care is with us at school. This will change with some families who are now able to obtain health care that was not previously available to them. Children make up 20 percent of our population, but 100 percent of our future. We also know that time in seats leads to academic success."

This connection to educational achievement is being underlined at the international symposium being held at the Hyatt Regency in Baltimore. The symposium is discussing the challenges associated with integrating health and social development programs more firmly within the core mandates, constraints and concerns of school systems. The spark for the event is an international consensus statement being developed by educators that is being presented in similar workshops in South East Asia, Europe, Australia and elsewhere.

Nursing representatives Yvette Laforet-Fliesser (Canada) and Erin Maughan (USA) will be making the case that if health systems want schools to truly adopt health promotion as a core part of their educational efforts, then the health sector needs to make an equivalent commitment to an ongoing role in supporting and working with schools through investing in school nursing programs.

"If the health system is slow or deficient in defining its long-term plan for supporting school-based and school-linked health promotion through nurses, then how can we expect educators to make a similar commitment?" say Laforet-Fliesser and Maughan.

"We cannot afford to respond to these issues in a piece-meal fashion, we need consistent, trained staff on site to meet the needs earlier and more effectively. It is time to strike a new bargain between health and education systems through adequate, evidence-based policy and programs".